DEPARTMENT OF INSURANCE

Affiliations

Name	Potter, Carlos Laroy	DOIID	887907	NAIC NPN	17638095

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	4/24/2017	4/30/2025
Active	Non Resident	Agent	Health	8/20/2015	4/30/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	02/15/2025	04/30/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Accendo Insurance Company	300312	Agent - Life	6/10/2020	4/23/2024
Active	Aetna Health Inc. (PA)	660717	Agent - Health	9/10/2019
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	9/20/2019	4/23/2024
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/28/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	9/10/2019
Inactive	American Continental Insurance Company	643130	Agent - Life	9/20/2019	8/11/2021
Inactive	CMFG Life Insurance Company	300929	Agent - Health	12/23/2020	6/11/2024
Inactive	CMFG Life Insurance Company	300929	Agent - Life	12/23/2020	6/11/2024
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	10/6/2016	11/7/2016
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	9/20/2019	4/23/2024
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/15/2016	6/8/2018
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/15/2016	2/23/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	10/15/2016	6/8/2018
Inactive	Humana Insurance Company	301104	Agent - Health	10/15/2016	6/8/2018
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/15/2016	6/8/2018
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/15/2016	6/8/2018
Inactive	Lumico Life Insurance Company	300354	Agent - Life	11/12/2019	7/8/2020
Active	SilverScript Insurance Company	663526	Agent - Health	8/23/2019
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	6/28/2019	11/20/2019
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	8/6/2019	11/20/2019
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	6/28/2019	11/20/2019
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	8/20/2015	12/15/2015
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	6/28/2019	11/20/2019
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	10/31/2019	12/30/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	10/31/2019	12/29/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	eHealthInsurance Services Inc.	514105	Agent - Health	7/31/2019	12/16/2019